Trends and Outcomes of ST-Segment-Elevation Myocardial Infarction Among Young Women in the United States

• Type of Material: Article
• Authors: Temidayo Abe, Vanderbilt University; Titilope Olanipekun, Vanderbilt University; Demilade Adedinsewo, Mayo Clinic; Oluseye Ogunmoroti, Johns Hopkins School of Medicine; Ndausug Udongwo, Jersey Shore University Medical Center; Valery Effoe, Morehouse School of Medicine; Bria Rice, Mayo Clinic; Ifeoma Onuorah, Emory University; Jalal K. Ghali, Morehouse School of Medicine; Puja Mehta, Emory University; Erin D. Michos, Johns Hopkins School of Medicine
• Language: English
• Date: 2023-03-07
• Publisher: WILEY
• Publication Version: Final Published Version
• Copyright Statement: © 2023 The Authors. Published on behalf of the American Heart Association, Inc., by Wiley.
• License: Creative Commons Attribution-NonCommercial 4.0 International
• Final Published Version (URL): http://dx.doi.org/10.1161/JAHA.122.026811
• Title of Journal or Parent Work: JOURNAL OF THE AMERICAN HEART ASSOCIATION
• Volume: 12
• Issue: 5
• Start Page: e026811
• End Page: e026811
• Grant/Funding Information: Dr Michos is supported by the Amato Fund in Women's Cardiovascular Health at Johns Hopkins and award number 946222 from the American Heart Association. Dr Adedinsewo receives research support from the Mayo Clinic Women's Health Research Center; the Mayo Clinic Building Interdisciplinary Research Careers in Women's Health (BIRCWH) Program funded by the National Institutes of Health, grant number K12HD065987; and Miami Heart Research Institute. The content is solely the responsibility of the authors and does not necessarily represent the official views of the National Institutes of Health or funding agencies.
• Keywords: young; Cardiovascular System & Cardiology; HEART-DISEASE; MORTALITY; STEMI; trends; CLINICAL CHARACTERISTICS; CARDIOVASCULAR-DISEASE RISK; ST-elevation myocardial infarction; Life Sciences & Biomedicine; SEX-DIFFERENCES; CARE; women; outcomes; Science & Technology; Cardiac & Cardiovascular Systems; MANAGEMENT
• Research Categories: Health Sciences, Medicine and Surgery

Abstract

BACKGROUND: Although there has been a decrease in the incidence of ST-segment–elevation myocardial infarction (STEMI) in the United States, this trend might be stagnant or increasing in young women. We assessed the trends, characteristics, and outcomes of STEMI in women aged 18 to 55 years. METHODS AND RESULTS: We identified 177 602 women aged 18 to 55 with the primary diagnosis of STEMI from the National Inpatient Sample during years 2008 to 2019. We performed trend analyses to assess hospitalization rates, cardiovascular disease (CVD) risk factor profile, and in-hospital outcomes stratified by three age subgroups (18–34, 35–44, and 45–55 years). We found STEMI hospitalization rates were decreased in the overall study cohort from 52 per 100 000 hospitalizations in 2008 to 36 per 100 000 in 2019. This was driven by decreased proportion of hospitalizations in women aged 45 to 55 years (74.2% to–71.7%; P<0.001). Proportion of STEMI hospitalizationincreased in women aged 18–34 (4.7%–5.5%; P<0.001) and 35–44 years (21.2%–22.7%; P<0.001). The prevalence of traditional and non-traditional female-specific or female-predominant CVD risk factors increased in all age subgroups. The adjusted odds of in-hospital mortality in the overall study cohort and age subgroups were unchanged throughout the study period. Additionally, we observed an increase in the adjusted odds of cardiogenic shock, acute stroke, and acute kidney injury in the overall cohort over the study period. CONCLUSIONS: STEMI hospitalizations are increasing among women aged <45 years, and in-hospital mortality has not changed over the past 12 years in women aged <55 years. Future studies on the optimization of risk assessment and management of STEMI in young women are urgently needed.